WARNING: This post is VERY long. Read at your own risk.
I was a Linguistics major in college. I know, I know, why study something useless like the study of language? Well, there is actually a lot you can do with it (who do you think helped create Google’s search algorithm) and teaching a foreign language doesn’t render it irrelevant either. I wasn’t really too worried about what I’d do with a Linguistics major when I started studying, all I knew was that all the classes that interested me were in the Linguistics department.
Studying Linguistics was a lot of fun; it was hard work but it was incredibly interesting. I enjoyed some really fascinating classes taught by well renowned professors. In one of those classes, Cognitive Linguistics, I was introduced to the idea of contested categories. We studied them more in Semantics, which is the study of the meaning of words.
At first glance it might seem facetious to dedicate an entire college course to the meanings of words, I mean isn’t that what dictionaries are for? The reality is words can mean much more than their mere definitions. The intention of an utterance sometimes veers drastically from the it’s dictionary definition. Sarcasm, irony, idiom, metaphor, cultural references, inside jokes, even the surroundings of a person can affect the meaning of words and phrases as they are uttered. When you really starting looking at it, it’s fascinating.
As far as definitions go, most words have pretty narrow denotations; these are the words that can be explained by limited entries in the dictionary. Other words are harder to pin down; some words have pages and pages of entries in the dictionary – entire columns of added prepositions creating entirely new phrases (get it, get up, get over it, get lost, etc). And some words might at first seem easily definable, but prove to be much more slippery and hard grasp a hold of.
Take “art” for example. What is art? Is art something that exists on a wall in a museum? Is art any painting or sculpture? Are murals art? If so, is graffiti art? What separates photographic art from the pictures you took on vacation? While you may think you know what “art” is, a probing inquiry would have you questioning yourself quite quickly.
Art is a contested category; it is a word that cannot be confined by everyone in the same way. While some things would probably be declared unanimously as art (Michaelangelo’s David), others linger on the edges of the definition, unsure of their place; one individual’s art (Banksy) is another’s public nuisance. In my head I visualize contested categories as Venn Diagram-like organizations with concentric circles here and overlapping circles there, the confines of which are ultimately blurry and difficult to determine.
I tackled a specific contested category in my final Semantics paper which was called The Contested Category and Metaphorical Extension of the Word “War”. It ended up being over 25 pages despite the requirement being a mere ten. Once I started digging into the difficulties of defining war I literally couldn’t stop. Is something a war only if two recognized nations with professional militaries are fighting? What if a country (the US) is fighting an amorphous terrorist group (Al Queda or Hamas) which lacks professional troops and exists in multiple countries? And what of the war on drugs? There are many who believe using the word “war” to define our stance against drugs has left the US with no other alternative than to “win” (stamp out all drug use) which is impossible. When we are at war with someone or something, any negotiated outcome that differs from the original goal is considered defeat.
Recently different articles and posts got me thinking about infertility as a contested category. Even before phrases like “circumstantial infertility” started getting thrown around I felt that infertility was a word consisting of concentric and overlapping circles, not to mentioned a blurred edge.
The American Heritage Dictionary’s definition (from dictionary.com) of infertility is:
- Absent or diminished fertility.
- The persistent inability to achieve conception and produce an offspring.
On the same dictionary.com page is a Medical Dictionary entry for infertile:
especially: incapable of or unsuccessful in achieving pregnancy over a considerable period of time (as a year) inspite of determined attempts by heterosexual intercourse without contraception
Of course everyone in the IF community knows it means much more than either of those things.
I’ve read many places that a couple is declared infertile if they’ve had unprotected sex for a year without achieving pregnancy. I’ve also read that for older couples the number goes down to six or sometime three months even though it will actually take older couples longerthan younger couples to get pregnant. This #-months-without-pregnancy definition seems more like a tool to provide couples with medical intervention; for that reason older couples can seek treatment more quickly, because their biological clocks are literally running out. Is one aspect of the word “infertility” only, in a way, a label to encourage treatment?
Infertility is caused by many things, some more easily explained than others. Infertility can be caused by hormone imbalances (thyroid issues, high FHS, POV), hardware malfunctions (uterine deformaties, scarring, lost/damaged fallopian tubes or ovaries), male-factor (low sperm count or motility) and conditions such as PCOS or endometriosis, to name a few. A large percentage of infertility cases are unexplained. For some women the problem is seemingly as simple as not ovulating. I suffered from unexplained amenorrhea (lack of menstruation) for years. For almost a decade I never had my period unless it was coaxed by months of birth control and even then it would only return for a few measly months. If I had tried to get pregnant during that time I would have been declared infertile.
At least I would have if I had waited for a year sans menstruation to ask for help. I think, though, that any doctor would have seen me after a few months of missing my period in which case they probably would have given me Clomid or some other drug to induce ovulation. When a person needs medical intervention to ovulate, but didn’t wait a year to take it, is she infertile? What about a woman who waits until she is 45 to try to conceive a child? When treatment is almost certainly necessary because of age, is that person infertile? Here is where the lines start to blur.
Western medicine provides many amazing remedies for infertility. Sometimes all that is needed is a drug to help spur ovulation. Other times more invasive treatments are necessary. Assisted Reproductive Technologies (ART) are as numerous as they are varied and they are a defining characteristic of infertility. Two common treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF). IUIs are less invasive (and less expensive) than IVF, which includes surgery for the woman. I have witness many women rating their (and others’) infertility based on the degree of treatments endured. Those who only need Clomid may be considered less infertile than those who undergo IUIs. If a heterosexual couple needs IVF it is an undeniable sign that infertility is present and it is generally agreed that those who undergo the procedure endure the most difficult treatment. Those who must opt for donor embryos or eggs or choose adoption may suffer even greater financial and emotional hardship. Classifying someone’s infertility by the treatment they’ve had to undergo or the suffering they’ve endured seems to be quite common and plays a role in defining the word.
Suffering, inherent not just in the treatment but in the very inability to conceive, is a huge part of the word infertility, and in many ways defines it as much as the medical explanations. Everyone who deals with infertility suffers because of it. There is so much loss – the loss of hope, the loss of innocence, the loss of expectations and dreams, the loss of achieving a biological imperative. For many the loss of pregnancies or babies is also a part of infertility. Some women have no trouble achieving pregnancy but are unable to carry a child to term, miscarrying repeatedly. While these women are not considered infertile by the medical establishment, the result is the same: years of waiting for a child they cannot have without help. This common experience of being unable to produce a living child is all that is needed to include these women in the infertility community.
The common thread of wanting a family and being unable to have one is also what inspired the co-opting of the word in the term “circumstantial infertility”. This term was coined to describe people who want to have children but have not yet found a partner with whom to start a family. This term has created some controversy in the infertility community, as many continue fighting for infertility to be seen as a true medical condition and not a lifestyle choice (as some claimed it to be). Still, most infertile women recognize that the pain felt by any person who is unable to build the family is legitimate and should be validated by everyone, even those people who are medically, not circumstantially, unable to conceive.
A final aspect of the word infertility is it’s resolution. All people who suffer infertility will make decisions that define their path and their eventual outcome. Some have success with ART and build their families as they would have had they not suffered the disease. Others have their own biological children via a surrogate or carry a child themselves via adopted embryos. Some people choose adoption to build them families and others choose (or are forced) to live childfree.
When infertile couples are no longer trying to build a family are they still infertile? What if a couple needs treatment to have her first child but then doesn’t to have their second? What about the other way around, commonly called secondary infertility? My friend told me of a woman who just had her second child via IVF and has decided to stop blogging in the infertility community as she no longer considers herself infertile; she had achieved the family she always hoped to have. Are those women who now have the families they had always wanted still infertile? Most bloggers I know believe that even if they consider their infertility resolved (they are no longer trying to conceive) they are still infertile, but then again, many of them did not achieve the family they had always hoped to.
Infertility is a medical term but it affects every aspect of a person’s life. This insidiously ubiquitous quality creates multiple arenas in which infertility is defined: the medical cause, the time and money spent trying to achieve a successful pregnancy, the medical intervention that is required, the inability to build a family when and how one had hoped, the eventual resolution of the disease and of course the agonizing loss and suffering endured. In fact, it seems that the pain of infertility is what creates the blurred edge containing all the concentric and over-lapping circles that construct infertility’s overall meaning. The suffering is what truly holds all the different pieces of the infertility experience together. And even if infertility can be described as a contested category, in the end, no matter how you define or categorize it, for those who’ve experienced it, infertility = devastating loss.
How do you define infertility? Is that definition based primarily on your experience and the experience of others? Do you believe infertility is a contested category, or do you find it easy to define?